SAMPLE SCHEDULE
REGIS TRATION FORM
http:// www.uvi.edu
1. The registration form must be COMPLETED PRIOR to entering the registration area, as it will be used to key your
course request(s). New students must complete page two.
2. Please make sure the COURSE REFERENCE NUMBER (CRN #) has been entered correctly. Schedules must have a
CRN# to be entered.
3. Changes in biographical data (name, address, telephone number) must be reported to the Registrar’s Office.
Fall
Spring
Summer I
Summer II
Year: ___ Date: _________ Student ID#__________________
Level:
Undergraduate
Graduate
Name:
Last First
M.I.
Tel: (Cell) (Home)
(Work)
Mailing Address: ______________________________________________________
Email: Emergency Contact: _____________________
Last Name First Name
Tel: (Cell)________________(Home) _________________ (Work) ____________________
CRN#
SUBJ
CRSE# SEC CRED DAY TIME AUDIT(Y/N)
OFFICE USE CRN#
SUBJ
CRSE# SEC
CRED
DAY TIME AUDIT: (Y/N)
Alternate Course Selection(s)
12345
MAT
231
A
4
MTWF
N
Total Credits:___________
____________________________________ _____________________________________
Advisor’s Signature Student’s Signature
Office Use:
PIP-Prerequisite in progress PNM-Prerequisite not met CTC-Course time conflict
CLS-Closed class CRN-Wrong CRN WTL-Waitlisted
CC-Cancelled class
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signature
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signature
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REGIS TRATION FORM
http:// www.uvi.edu
Social Security Number #__________________
Fall
Spring
Summer I
Summer II
20 ___
Campus: STT STX
Level:
Undergraduate Graduate
Name: _
Last First Middle Maiden
Physical Address: Local Mailing Address:
Zip Zip
Phone: Home ( _) - Work: ( )
-
Ext.
Sex: Male Female U.S. Citizen Yes No
Date of Birth: Permanent Resident
Alien Registration #
Non Resident Alien: Type of Visa F J H
In compliance with federal reporting requirements, UVI must seek to identify the ethnic background of
students enrolled. You are encouraged to supply this information.
Black/Non-Hispanic
Asian/Pacific Islander
White/Non-Hispanic
American Indian/Alaskan
Hispanic
Other
Have you lived in the Virgin Islands for the past twelve (12) months? Yes No
In what state/country is your permanent residence? _ _____
Year of last attendance at UVI __________________________________________________
I certify that the information given on this form is complete and correct. I acknowledge that deliberate
omissions or falsifications may subject me to immediate dismissal from the University.
Under the provisions of the Family Educational Rights and Privacy Act of 1974, as amended, you have the
right to withhold the disclosure of any directory information.
If you would like that your name not be listed in a directory please indicate: Yes No
Student’s Signature Date
Page 2
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signature
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